ATI Comprehensive Predictor Updated 2026 | Nursing Comprehensive
Exam Study Guide, Practice Exam Questions and Answers, NCLEX
Readiness Test Bank, Medical-Surgical Nursing Review, Pharmacology
Concepts, Maternal Newborn Care, Pediatric Nursing, Mental Health
Nursing, Leadership and Management, Prioritization and Clinical
Judgment, and Detailed Rationales for Exam Preparation Success
Question 1: A nurse is preparing to administer a blood transfusion to a client who
has anemia. Which of the following actions should the nurse take first?
A. Verify the client's identity using two identifiers
B. Obtain the client's vital signs
C. Prime the IV tubing with normal saline
D. Document the transfusion in the electronic medical record
CORRECT ANSWER: A. Verify the client's identity using two identifiers
Rationale: The first action the nurse should take is to verify the client's identity using
two identifiers (e.g., name and date of birth) to ensure the correct blood product is
administered to the correct client. This is a critical safety step before initiating the
transfusion.
Question 2: A client who is post-operative day one following a total hip arthroplasty
reports sudden chest pain and shortness of breath. Which of the following
complications should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Incisional pain
CORRECT ANSWER: B. Pulmonary embolism
Rationale: Sudden chest pain and shortness of breath in a post-operative client,
especially following orthopedic surgery, are classic signs of a pulmonary embolism
(PE). This is a life-threatening complication that requires immediate intervention.
Question 3: A nurse is assessing a client who has a sodium level of 155 mEq/L.
Which of the following findings should the nurse expect?
A. Muscle cramps
B. Hypotension
C. Edema
D. Thirst
CORRECT ANSWER: D. Thirst
Rationale: A sodium level of 155 mEq/L indicates hypernatremia. Thirst is an early and
primary sign of hypernatremia as the body attempts to increase water intake to dilute
the elevated serum sodium concentration.
Question 4: A nurse is caring for a client with a new diagnosis of type 1 diabetes
mellitus. The client asks, "Why do I need to take insulin injections?" Which of the
following responses is most appropriate?
A. "Your body is resistant to the insulin your pancreas produces."
,B. "Your pancreas is not producing enough insulin."
C. "Your body produces too much glucose."
D. "Your immune system destroys the cells that produce insulin."
CORRECT ANSWER: D. Your immune system destroys the cells that produce
insulin.
Rationale: Type 1 diabetes is an autoimmune condition in which the immune system
attacks and destroys the beta cells in the pancreas, leading to absolute insulin
deficiency. Therefore, exogenous insulin is required.
Question 5: A nurse is performing a physical assessment on a client who has heart
failure. Which of the following findings is an early indicator of fluid volume
overload?
A. Dyspnea
B. Peripheral edema
C. Jugular venous distention
D. Weight gain
CORRECT ANSWER: D. Weight gain
Rationale: Weight gain is an early indicator of fluid volume overload, often occurring
before other signs such as dyspnea or edema. Daily weights are a sensitive measure for
detecting fluid retention.
Question 6: A nurse is providing discharge teaching to a client who has a
prescription for warfarin. Which of the following client statements indicates an
understanding of the teaching?
A. "I will eat more leafy green vegetables."
B. "I will take ibuprofen for my headaches."
C. "I will report any unusual bruising or bleeding."
D. "I will take my warfarin with a glass of milk."
CORRECT ANSWER: C. I will report any unusual bruising or bleeding.
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. The client
should be taught to report any signs of bleeding, such as unusual bruising, bleeding
gums, or blood in the stool.
Question 7: A nurse is caring for a client who has a chest tube following a
pneumothorax. Which of the following actions is most important for the nurse to
take?
A. Clamp the chest tube when moving the client
B. Ensure the drainage system is below the client's chest level
C. Strip the chest tube every 4 hours
D. Maintain the client in a supine position
CORRECT ANSWER: B. Ensure the drainage system is below the client's chest level
Rationale: The chest tube drainage system must be kept below the level of the client's
chest to facilitate gravity drainage and prevent backflow of fluid into the pleural space.
Question 8: A nurse is reviewing the laboratory results of a client who is receiving
furosemide. Which of the following findings should the nurse report to the
,provider?
A. Serum sodium of 140 mEq/L
B. Serum potassium of 3.0 mEq/L
C. Serum calcium of 9.5 mg/dL
D. Serum magnesium of 2.0 mEq/L
CORRECT ANSWER: B. Serum potassium of 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. A serum
potassium level of 3.0 mEq/L is below the normal range (3.5-5.0 mEq/L) and should be
reported, as it can lead to cardiac arrhythmias.
Question 9: A nurse is providing instructions to a client who has a prescription for
an iron supplement. Which of the following statements by the client indicates a
need for further teaching?
A. "I will take the iron with orange juice."
B. "I will take the iron with meals to decrease stomach upset."
C. "I will expect my stools to turn dark."
D. "I will report any black, tarry stools."
CORRECT ANSWER: D. I will report any black, tarry stools.
Rationale: Black, tarry stools can be a sign of gastrointestinal bleeding and should be
reported. While iron supplements can cause dark green or black stools, they are usually
not tarry. This indicates a misunderstanding that requires further teaching.
Question 10: A nurse is assessing a client for signs of withdrawal from alcohol.
Which of the following findings should the nurse expect to see first?
A. Seizures
B. Delirium tremens
C. Hand tremors
D. Hallucinations
CORRECT ANSWER: C. Hand tremors
Rationale: Hand tremors are an early sign of alcohol withdrawal, often occurring within
hours of the last drink. More severe symptoms like seizures and delirium tremens
typically occur later (24-72 hours).
Question 11: A nurse is caring for a client who has a new diagnosis of hypertension.
Which of the following lifestyle modifications should the nurse recommend to the
client?
A. Increase intake of red meat
B. Restrict fluid intake
C. Reduce sodium intake
D. Increase intake of processed foods
CORRECT ANSWER: C. Reduce sodium intake
Rationale: Reducing sodium intake is a key lifestyle modification for managing
hypertension. The DASH diet (Dietary Approaches to Stop Hypertension) is often
recommended and includes reducing sodium, increasing fruits and vegetables, and
choosing whole grains.
, Question 12: A nurse is preparing a client for surgery. The client asks, "Why do I
have to sign this consent form?" Which of the following responses is most
appropriate?
A. "It is a legal requirement before any procedure."
B. "It allows the doctor to perform the surgery."
C. "It ensures you are protected from liability."
D. "It is a hospital policy that we must follow."
CORRECT ANSWER: B. It allows the doctor to perform the surgery.
Rationale: The purpose of the informed consent is to give the physician legal authority
to perform the procedure. It indicates that the client understands the risks, benefits,
and alternatives.
Question 13: A nurse is assessing a client's pain level using a 0-10 numeric rating
scale. The client reports a pain level of 8. Which of the following is the nurse's
priority action?
A. Administer prescribed pain medication
B. Ask the client to describe the pain
C. Reposition the client and provide comfort measures
D. Document the pain assessment and intervention
CORRECT ANSWER: A. Administer prescribed pain medication
Rationale: The priority is to intervene to relieve the client's pain. A pain level of 8
indicates severe pain, and the nurse should administer the prescribed analgesic
promptly.
Question 14: A nurse is caring for a client who has a nasogastric (NG) tube attached
to intermittent suction. Which of the following findings indicates that the tube is
correctly placed?
A. The client is able to speak clearly
B. The pH of the aspirated fluid is 5.0
C. The tube is secured with tape to the client's nose
D. The drainage is clear
CORRECT ANSWER: B. The pH of the aspirated fluid is 5.0
Rationale: The pH of gastric fluid is typically acidic (1-5). A pH of 5.0 is within the
expected range for gastric fluid, indicating that the NG tube is likely in the stomach.
Question 15: A nurse is providing education to a client about the use of a
continuous positive airway pressure (CPAP) device. Which of the following
conditions is the CPAP primarily used to treat?
A. Asthma
B. Pneumonia
C. Obstructive sleep apnea
D. Tuberculosis
CORRECT ANSWER: C. Obstructive sleep apnea
Rationale: CPAP is the primary treatment for obstructive sleep apnea. It delivers a
continuous stream of air to keep the airway open during sleep.
Exam Study Guide, Practice Exam Questions and Answers, NCLEX
Readiness Test Bank, Medical-Surgical Nursing Review, Pharmacology
Concepts, Maternal Newborn Care, Pediatric Nursing, Mental Health
Nursing, Leadership and Management, Prioritization and Clinical
Judgment, and Detailed Rationales for Exam Preparation Success
Question 1: A nurse is preparing to administer a blood transfusion to a client who
has anemia. Which of the following actions should the nurse take first?
A. Verify the client's identity using two identifiers
B. Obtain the client's vital signs
C. Prime the IV tubing with normal saline
D. Document the transfusion in the electronic medical record
CORRECT ANSWER: A. Verify the client's identity using two identifiers
Rationale: The first action the nurse should take is to verify the client's identity using
two identifiers (e.g., name and date of birth) to ensure the correct blood product is
administered to the correct client. This is a critical safety step before initiating the
transfusion.
Question 2: A client who is post-operative day one following a total hip arthroplasty
reports sudden chest pain and shortness of breath. Which of the following
complications should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Incisional pain
CORRECT ANSWER: B. Pulmonary embolism
Rationale: Sudden chest pain and shortness of breath in a post-operative client,
especially following orthopedic surgery, are classic signs of a pulmonary embolism
(PE). This is a life-threatening complication that requires immediate intervention.
Question 3: A nurse is assessing a client who has a sodium level of 155 mEq/L.
Which of the following findings should the nurse expect?
A. Muscle cramps
B. Hypotension
C. Edema
D. Thirst
CORRECT ANSWER: D. Thirst
Rationale: A sodium level of 155 mEq/L indicates hypernatremia. Thirst is an early and
primary sign of hypernatremia as the body attempts to increase water intake to dilute
the elevated serum sodium concentration.
Question 4: A nurse is caring for a client with a new diagnosis of type 1 diabetes
mellitus. The client asks, "Why do I need to take insulin injections?" Which of the
following responses is most appropriate?
A. "Your body is resistant to the insulin your pancreas produces."
,B. "Your pancreas is not producing enough insulin."
C. "Your body produces too much glucose."
D. "Your immune system destroys the cells that produce insulin."
CORRECT ANSWER: D. Your immune system destroys the cells that produce
insulin.
Rationale: Type 1 diabetes is an autoimmune condition in which the immune system
attacks and destroys the beta cells in the pancreas, leading to absolute insulin
deficiency. Therefore, exogenous insulin is required.
Question 5: A nurse is performing a physical assessment on a client who has heart
failure. Which of the following findings is an early indicator of fluid volume
overload?
A. Dyspnea
B. Peripheral edema
C. Jugular venous distention
D. Weight gain
CORRECT ANSWER: D. Weight gain
Rationale: Weight gain is an early indicator of fluid volume overload, often occurring
before other signs such as dyspnea or edema. Daily weights are a sensitive measure for
detecting fluid retention.
Question 6: A nurse is providing discharge teaching to a client who has a
prescription for warfarin. Which of the following client statements indicates an
understanding of the teaching?
A. "I will eat more leafy green vegetables."
B. "I will take ibuprofen for my headaches."
C. "I will report any unusual bruising or bleeding."
D. "I will take my warfarin with a glass of milk."
CORRECT ANSWER: C. I will report any unusual bruising or bleeding.
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. The client
should be taught to report any signs of bleeding, such as unusual bruising, bleeding
gums, or blood in the stool.
Question 7: A nurse is caring for a client who has a chest tube following a
pneumothorax. Which of the following actions is most important for the nurse to
take?
A. Clamp the chest tube when moving the client
B. Ensure the drainage system is below the client's chest level
C. Strip the chest tube every 4 hours
D. Maintain the client in a supine position
CORRECT ANSWER: B. Ensure the drainage system is below the client's chest level
Rationale: The chest tube drainage system must be kept below the level of the client's
chest to facilitate gravity drainage and prevent backflow of fluid into the pleural space.
Question 8: A nurse is reviewing the laboratory results of a client who is receiving
furosemide. Which of the following findings should the nurse report to the
,provider?
A. Serum sodium of 140 mEq/L
B. Serum potassium of 3.0 mEq/L
C. Serum calcium of 9.5 mg/dL
D. Serum magnesium of 2.0 mEq/L
CORRECT ANSWER: B. Serum potassium of 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. A serum
potassium level of 3.0 mEq/L is below the normal range (3.5-5.0 mEq/L) and should be
reported, as it can lead to cardiac arrhythmias.
Question 9: A nurse is providing instructions to a client who has a prescription for
an iron supplement. Which of the following statements by the client indicates a
need for further teaching?
A. "I will take the iron with orange juice."
B. "I will take the iron with meals to decrease stomach upset."
C. "I will expect my stools to turn dark."
D. "I will report any black, tarry stools."
CORRECT ANSWER: D. I will report any black, tarry stools.
Rationale: Black, tarry stools can be a sign of gastrointestinal bleeding and should be
reported. While iron supplements can cause dark green or black stools, they are usually
not tarry. This indicates a misunderstanding that requires further teaching.
Question 10: A nurse is assessing a client for signs of withdrawal from alcohol.
Which of the following findings should the nurse expect to see first?
A. Seizures
B. Delirium tremens
C. Hand tremors
D. Hallucinations
CORRECT ANSWER: C. Hand tremors
Rationale: Hand tremors are an early sign of alcohol withdrawal, often occurring within
hours of the last drink. More severe symptoms like seizures and delirium tremens
typically occur later (24-72 hours).
Question 11: A nurse is caring for a client who has a new diagnosis of hypertension.
Which of the following lifestyle modifications should the nurse recommend to the
client?
A. Increase intake of red meat
B. Restrict fluid intake
C. Reduce sodium intake
D. Increase intake of processed foods
CORRECT ANSWER: C. Reduce sodium intake
Rationale: Reducing sodium intake is a key lifestyle modification for managing
hypertension. The DASH diet (Dietary Approaches to Stop Hypertension) is often
recommended and includes reducing sodium, increasing fruits and vegetables, and
choosing whole grains.
, Question 12: A nurse is preparing a client for surgery. The client asks, "Why do I
have to sign this consent form?" Which of the following responses is most
appropriate?
A. "It is a legal requirement before any procedure."
B. "It allows the doctor to perform the surgery."
C. "It ensures you are protected from liability."
D. "It is a hospital policy that we must follow."
CORRECT ANSWER: B. It allows the doctor to perform the surgery.
Rationale: The purpose of the informed consent is to give the physician legal authority
to perform the procedure. It indicates that the client understands the risks, benefits,
and alternatives.
Question 13: A nurse is assessing a client's pain level using a 0-10 numeric rating
scale. The client reports a pain level of 8. Which of the following is the nurse's
priority action?
A. Administer prescribed pain medication
B. Ask the client to describe the pain
C. Reposition the client and provide comfort measures
D. Document the pain assessment and intervention
CORRECT ANSWER: A. Administer prescribed pain medication
Rationale: The priority is to intervene to relieve the client's pain. A pain level of 8
indicates severe pain, and the nurse should administer the prescribed analgesic
promptly.
Question 14: A nurse is caring for a client who has a nasogastric (NG) tube attached
to intermittent suction. Which of the following findings indicates that the tube is
correctly placed?
A. The client is able to speak clearly
B. The pH of the aspirated fluid is 5.0
C. The tube is secured with tape to the client's nose
D. The drainage is clear
CORRECT ANSWER: B. The pH of the aspirated fluid is 5.0
Rationale: The pH of gastric fluid is typically acidic (1-5). A pH of 5.0 is within the
expected range for gastric fluid, indicating that the NG tube is likely in the stomach.
Question 15: A nurse is providing education to a client about the use of a
continuous positive airway pressure (CPAP) device. Which of the following
conditions is the CPAP primarily used to treat?
A. Asthma
B. Pneumonia
C. Obstructive sleep apnea
D. Tuberculosis
CORRECT ANSWER: C. Obstructive sleep apnea
Rationale: CPAP is the primary treatment for obstructive sleep apnea. It delivers a
continuous stream of air to keep the airway open during sleep.
